Navigating the Health Care System

There is a truism in health care: When you don't fully understand or can't act on information about your health care, you are more likely to be in poorer health.

Nearly all of us, about 9 of every 10 American adults, have some problems with health literacy.

Health literacy is not only about reading. It's about understanding difficult health terms and issues. Even highly educated people can have trouble understanding health care information.

For example, health literacy plays a role in how well:

• Someone is able to take the right medicine at the right time.
• A person with diabetes properly manages the condition.
• A parent follows instructions for helping a child recover from surgery.

Health care is complicated and the health care system can be confusing. That's why so many people have trouble understanding information about their health and health care options. Older adults, minorities, immigrants whose first language isn't English, poor adults, and people with ongoing mental and physical conditions are more likely to have a hard time. But everyone can have trouble sometimes, especially when you're sick or have just been told you have a disease.

Limited health literacy can literally harm your health. If you have trouble understanding instructions, you may have a hard time managing a health condition or taking your medicines correctly. You may end up in the hospital more, spend more on health care, and have poorer health. Limited health literacy can also decrease your chances of getting important tests, like mammograms, or helping a loved one with his or her care.

Doctors, nurses, pharmacists, and hospitals can all play a role in helping patients better understand and use health information.

To help, the Federal Government in May announced a national effort to make health information more straightforward and understandable.

My agency, the Agency for Healthcare Research and Quality, has developed tools to help doctors and their office staffs improve communication with all patients so they can better understand a doctor's instructions and other important medical information. Another tool helps pharmacists talk to patients about how to use drugs safely.

While these efforts can help, you can take steps, too. To improve your health literacy:

• Ask questions. Then, make sure you get and understand the answers. If you don't understand, ask the doctor or nurse for more information. Asking questions may not always be easy, but it can get you the information you need to take better care of yourself. To help you, my agency developed a list of questions you can bring to the doctor, the pharmacist, or the hospital.
• Repeat information back to your doctor or nurse. After your doctor or nurse gives you directions, repeat those instructions in your own words. Simply say, "Let me see if I understand this." This gives you a chance to clarify information. Studies show that doctors and patients often have very different ideas of what the patient is going to do after leaving the doctor's office. For example, if a clinician advises you to 'take two' Coumadin, it is really important to know if they mean 2 milligrams—or two pills. Repeating back can help avoid potentially serious mistakes.
• Bring all your medicines to your next doctor's visit. Ask your doctor to go over all of your drugs and supplements, including vitamins and herbal medicines. More than one third of adults struggle to understand how to take their medicines. Reviewing your medicines can help you and your doctor. You may even discover some mistakes, such as two drugs that shouldn't be taken together.
• Have another adult with you. This might be especially true when you expect to receive important information.
• Let the doctor's office know you need an interpreter if you don't speak or understand English very well. You have a right to an interpreter, at no cost to you. Even if you speak some English, tell the doctor's office what language you prefer when you make an appointment.
• Make a Pill Card. My agency has published step-by-step instructions to create an easy-to-use Pill Card to help patients, parents, and others keep track of medicines.

With Health Literacy Month coming up in October, this is a good time to try these suggestions. You might even improve your health—or the health of someone you care about.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

 

More Information

AHRQ Podcast
Health Literacy Limited for Many Americans (Transcript)

Agency for Healthcare Research and Quality
Questions are the Answer: Build Your Question List
https://www.ahrq.gov/questions/qb/

U.S. Department of Health and Human Services
Healthfinder.org
http://www.healthfinder.gov/

The National Action Plan to Improve Health Literacy
http://www.hhs.gov/ophs/news/20100527.html

National Institute for Literacy
America's Literacy Directory
http://literacydirectory.org